UCL helps paraplegics get back on their bikes

Paralysed people could soon be cycling around London, thanks to a novel sports
centre which will offer many of those disabled from a spinal cord injury the
chance to get back on a bike.

University College London (UCL) is planning the world’s first Functional
Electrical Stimulation (FES) Sports Centre, to help paraplegics to buy adapted
tricycles with FES equipment to enable them to cycle using their leg muscles.

In FES-cycling, paralysed muscles are stimulated by passing short pulses of
current through electrodes on the skin, which moves the legs. A stimulator synchronizes
the stimulation with the pedal position while the person has a ‘throttle’
to control how much stimulation is applied - rather like a motor bike with the
legs as the engine.

All the necessary FES equipment will soon be commercially available - most
can already be bought on the internet – which is why UCL’s Professor
Nick Donaldson wants to create the centre as a support service and catalyst
to encourage new users to take up FES cycling. He estimates that roughly half
of those affected will be able to take up the sport.

Professor Donaldson, of UCL’s Implanted Devices Group, says: “We’re
in a similar situation to Benjamin Franklin after he invented bifocal glasses.
People could only benefit from the invention when there were opticians who could
measure customers’ eyesight and get suitable spectacles made. The FES
Sports Centre will have an equivalent role, assessing people’s suitability,
giving advice on re-training paralysed muscles and helping people to buy the
right equipment.”

The centre, to be based in London and estimated to cost £500k until it
becomes self-supporting, will offer a range of services including support for
people who wish to take up FES-rowing. For those who can’t afford the
equipment – trikes cost up to £3,000 and stimulators another £1,000
- staff will offer advice on how to apply to charities for assistance. For researchers
like Prof Donaldson, the centre will make it easier to recruit people for studies
to fine-tune and improve on the technology.

Professor Donaldson’s group, along with that of Professor Ken Hunt at
the University of Glasgow, have already received funding from the Engineering
and Physical Sciences Research Council to produce a film to be distributed to
potential users that will explain what FES can do. They are also running a separate
EPSRC study which is currently assessing the health benefits of FES-cycling
exercise for paraplegics.

Prof Donaldson continues: “Spinal cord injury leads to paralysis, muscle
wastage, loss of bone density and poor circulation. That means high risk of
bone fracture, pressure sores that can take a long time to cure or may even
be fatal and difficulty in getting enough cardiac exercise. Many people with
a disabling spinal injury could make use of FES, but at present it remains primarily
a research tool, used in a handful of labs such as ours, so the only people
who use it are those taking part in studies. We want to offer a public FES service
through this pilot centre and we hope other centres will spring up.

“A few of our patients have trained enough to cycle long distances and
produce nearly as much power as non-disabled not-very-fit cyclists. But most
produce much less power, partly because muscles that are activated artificially
are about three times less efficient. We don’t yet know what the upper
limits are for power or endurance, which is why we need to keep recruiting people
for our research.

“We estimate that around half of paraplegics will be able to take up
FES cycling. Those with lesions higher up the spine have reduced arm and hand
function, making it difficult for them to transfer from wheelchairs to trikes,
and at present this is a limitation.

“FES exercise is not just about improving health, but about enabling
paralysed people to enjoy activities that you and I take for granted. We are
planning the first ever FES International Games - where Olympics will meet Formula
One - as people train to boost their cycling speed while bioengineers fine tune
the trikes and stimulators.”

Notes to editors:

The FES Sports Centre is one of many projects that will feature in the Campaign
for UCL launching on the Wednesday 6 October 2004. A press briefing on the Campaign
will be held at 10am followed by a demonstration of how FES works at 11am.